FOOD AND BEVERAGE INTEREST SUBMISSION
CUSTOMER INFORMATION
Customer Name
Customer Phone #
Customer Email Address
Customer Account/Site #
SALES CONSULTANT INFO
NCD DIVISION / DISTRIBUTION CENTER
Please select...
CHICOPEE / NORTH / POLEP
FARMINGDALE / CENTRAL / HLA
PHILADELPHIA / SOUTH / ALLEN BROTHERS
ROCKVILLE DC / CENTURY
TAMPA / COLONIAL
I DON'T KNOW
Your NCD sales consultant name (if known)
TEST KITCHEN BOOKING
I would like to schedule an on-site Test Kitchen Experience at an NCD office
Please select...
Yes!
Not right now
Please choose which location you prefer meeting at
Please select...
Chicopee, Massachusetts Office
Farmingdale, New York Office
Don't Know
When is your preferred timing for this appointment?
Please select...
As soon as possible
In 2-4 weeks
In 4-6 weeks
2-6 Months
6-12 Months
NEXT YEAR
Since we will be scheduling a test kitchen experience, feel free to submit the form without filling out any of the other questions below, as we will have an in-depth discussion on your needs and survey your current situation. Up to you.
FOOD + BEVERAGE STORE SURVEY
BEVERAGE
Do you currently offer a COFFEE / HOT beverage program?
Please select...
Yes
No
Unsure
If yes, which coffee brand is most prominent in your store(s)?
Please select...
Baronet
Bean Town
Caribou
Chock Full 'O Nuts
Green Mountain
Illy
Island Coffee
Lavazza
Nespresso
New England Coffee
Peet's
Starbucks
Other
Unsure
NONE
Interested in NCD's coffee brands below?
Please select...
Not Interested
Island Coffee
Bean Town (New England Only)
Baronet
Chock Full 'O Nuts
Green Mountain
New England Coffee
Other
Approximately, how many
pounds
of coffee per week do you sell?
Is this location clean and sanitary for Beverage programs?
Please select...
Yes
No
Is there a water line with fitting?
Please select...
Yes
No
Electric 110v
Electric 110v 20
amp (VKI only)
Electric 220 v L1430 plug style required
Outlets for Beverage Information
Enter how many
Enter how many
Enter how many
Is there a drain in the counter?
Please select...
Yes
No
Does the customer
OWN
any of their equipment?
Please select...
Yes
No
Dimensions of Beverage Counter
Be detailed with inches/feet/height/width/length
BEVERAGE AREA - UPLOAD A PICTURE
FOOD SERVICE
CUSTOMERS NEED TO HAVE SERV SAFE, 3 COMPARTMENT SINK, AND A FOOD LICENSE
Does the customer have their serv safe and food license?
Please select...
Yes
No
It's pending
Does this store have a 3 compartment sink and proper cleaners?
Please select...
Yes
No
Does this store have a food prep area?
Please select...
Yes
No
Is there a hand wash sink near the food prep area?
Please select...
Yes
No
Does this store have enough fridge and freezer space?
Please select...
Yes
No
Does this store have enough employees to handle prepared food?
Please select...
Yes
No
Does this store have an oven?
Please select...
Yes
No
OVEN - UPLOAD PICTURE(s)
Does this store have a warmer?
Please select...
Yes
No
WARMER - UPLOAD PICTURE(s)
Does this customer need to purchase new equipment?
Please select...
Yes
No
WHICH EQUIPMENT IS THE SALES CONSULTANT RECOMMENDING?
FOOD AREA - UPLOAD PICTURE(s)
OTHER PROGRAM INTEREST
BEVERAGE INTEREST
Please select...
CAPPUCCINO MACHINE
BEAN TO CUP
SLUSH
F'REAL
PURE BUBBLER
SMOODI
SELECT ALL THAT APPLY
FOOD SERVICE INTEREST
Please select...
MIGHTY CHICKEN
MY PIE
ROLLER GRILL PROGRAM
BELLARICO PIZZA
SOUP PROGRAM
COOKIE PROGRAM
RACHAEL'S
CRAFT HOUSE
ICE CREAM
OTHER SANDWICH PROGRAM
SELECT ALL THAT APPLY
EQUIPMENT INTEREST
Please select...
TURBO CHEF
WARMER
WARING PIZZA OVEN
OPEN AIR COOLER
HUMIDOR
OTHER
SELECT ALL THAT APPLY
COMMENTS/NOTES/OTHER